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Objectives: To pilot an exploration of older adults' future preferences using discrete choice experiments to understand who should provide dental examinations and treatment, where these services should be provided, and participants' willingness to pay and willingness to travel. Background: The proportion of older adults in the general population is increasing and is recognised as a pressing public health challenge. Materials and Methods: Older people aged 65 years and over were recruited into this study from the UK, Switzerland and Greece. Drawing on earlier stakeholder engagement, a set of choice experiments are developed to explore the future preferences of older people for dental examinations and dental treatment, as they anticipated losing their independence. These were presented to the participants using a range of platforms, because of the COVID pandemic. Data were analysed in STATA using a random‐effects logit model. Results: Two hundred and forty‐six participants (median age 70 years) completed the pilot study. There was a strong preference across all countries for a dentist to undertake a dental examination (Greece: β = 0.944, Switzerland: β = 0.260, UK β = 0.791), rather than a medical doctor (Greece: β = −0.556, Switzerland: β = −0.4690, UK: β = −0.468). Participants in Switzerland and the UK preferred these examinations to be undertaken in a dental practice (Switzerland: β = 0.220, UK: β = 0.580) while participants in Greece preferred the dental examination to be undertaken in their homes (β = 1.172). Greek participants preferred dental treatment to be undertaken by a specialist (β = 0.365) in their home (β = 0.862), while participants from the UK and Switzerland preferred to avoid any dental treatment at home (Switzerland: β = −0.387; UK: β = −0.444). Willingness to pay analyses highlighted that participants in Switzerland and the UK were willing to pay more to ensure the continuity of future service provision at a family dental practice (Switzerland: β = 0.454, UK: β = 0.695). Conclusion: Discrete choice experiments are valuable for exploring older people's preferences for dental service provision in different countries. Future larger studies should be conducted to further explore the potential of this approach, given the pressing need to design services that are fit for purpose for older people. Continuity of dental service provision is considered as important by most older people, as they anticipate losing their dependence. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of overnight storage conditions on the dimensional stability and retention of prostheses, as well as participants' subjective perceptions of these interventions. Materials and Methods: Subjects with maxillary complete prostheses (CRPs) were randomly assigned to receive two interventions in a crossover design: storage of their CRPs overnight in a dry environment or in a wet environment with a cleansing tablet. The denture intaglio surface was scanned, and outcome measures were collected before each intervention (BLN), postintervention (PIS), and after immersion in water for 15 minutes (WOC) following each intervention. Dimensional changes were analyzed for the total surface, anterior flange, palate, and tuberosities. Retention force was measured using a dynamometer, and the participants' subjective assessments of comfort, fit, and retention of their CRPs were collected. After verifying normal distribution, paired t and Wilcoxon signed rank tests were used to check for statistical significance (α = .05). Results: Ten participants (mean age: 76.5 ± 5.9 years) were recruited. Between BLN and PIS, the dimensional changes after dry intervention were significantly less than the wet intervention for the total surface (P = .009), anterior flange (P = .028), and palate (P = .005). No difference was found between the effects of storage or washout interventions on objectively measured CRP retention. However, after WOC following dry storage, participants perceived a lower retention (P = .021), and after WOC following wet storage, participants perceived a more comfortable palate (P = .018). Conclusion: For dimensional stability, dry overnight storage of removable prostheses can be safely recommended when indicated. Immersion in water for 15 minutes does not seem to add advantages. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of operator age on the scan accuracy (trueness and precision) of inexperienced operators when compared with experienced operators, and how training, intraoral scanner (IOS), and software version affect scan accuracy. Material and Methods: Thirty‐four operators were sorted into groups: G1 (operators <25 years old, no experience), G2 (operators >40 years old, no experience), and G3 (experienced IOS operators). They conducted partial‐arch scans before and after a 4‐session training with two IOSs (Trios 3 and True Definition) and two software versions. These scans were compared with the reference scans obtained from conventional impressions and a laboratory scanner (IScan D103i) to evaluate trueness (mean root mean square values) and precision (standard deviation of root mean square values) with a software program (Geomagic Control X). Kruskal‐Wallis and post‐hoc Dunn's tests were used to evaluate the effect of age on the scan accuracy of inexperienced groups when compared with experienced operators, while the effect of training, IOS, and software version on scan accuracy was evaluated with Wilcoxon or Mann‐Whitney U tests (α = 0.05). Results: Before training, G1 and G2 scans had similar accuracy (p ≥ 0.065). After training, G1 scans had higher accuracy when IOS data was pooled and had higher precision with TD (p ≤ 0.004). Training increased the scan accuracy (p < 0.001), while newer software increased the trueness of inexperienced operator scans (p = 0.015). Conclusions: Age affected the scan accuracy of inexperienced operators after training, indicating that extended training may be required for older operators. Training increased the scan accuracy, and newer software increased the trueness of inexperienced operator scans. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the differences in accuracy (trueness and precision) of five different optical impression systems.Materials and Methods: The accuracy of the following optical impression systems was tested: (1) CEREC Bluecam (BL; Dentsply Sirona), (2) CEREC Omnicam (OM, Dentsply Sirona); (3) PlanScan (PL; Planmeca); (4) True Definition Scanner (TD; 3M ESPE); and (5) Trios 3 (TR; 3Shape). A standard plastic study model represented a patient with a fully dentate maxilla (ANA-4 V CER, frasaco). Three clinical situations were simulated: Patient 1 (P1): fully dentate; Patient 2 (P2): anterior partial edentulism (two missing incisors); and Patient 3 (P3): posterior partial edentulism (P3) (missing premolar and molar). The models were scanned with a reference scanner (IScan D104i, Imetric), and the digitalized models were used as reference for all comparisons. Then, optical impressions were made for the three clinical scenarios (n = 10 per group).Results: In situation P1, the TD group provided the highest trueness (180.2 ± 46.3μm). In situation P2, the highest trueness was found in the TD (97.9 ± 27.6 μm) and TR (105 ± 9.5μm) groups, and in situation P3, TR had the highest trueness (P < .05) with a median RMS value of 76.2 ± 5.6 μm. In terms of precision, TR provided the highest precision (P < .05) in all three clinical situations, with RMS values 76.7 ± 26 μm for P1, 46.8 ± 14.1 μm for P2, and 39.7 ± 9.1 μm for P3.Conclusion: Two optical impression systems (TR and TD) were superior to the other tested systems in most of the measurements. However, none of the tested systems was clearly superior with respect to both trueness and precision. [ABSTRACT FROM AUTHOR]

Scanning edentulous arches during complete denture fabrication is a crucial step; however, the quality of the resulting digital scan is still questionable. The purpose of this study is to systematically review studies (both clinical and in vitro) and determine whether intraoral scanners have clinically acceptable accuracy when recording completely edentulous arches for the fabrication of removable complete dentures. An electronic search in medical databases like PubMed, Scopus, and Web of Science (WOS), using a combination of relevant keywords, retrieved 334 articles. After full-text evaluation, twelve articles fulfilled the inclusion criteria for this review (eight clinical studies and four in vitro studies). A quality analysis of the included studies was carried out using the QUADAS-2 tool. The accuracy values varied between different intraoral scanners. Different regions of the edentulous arches showed differences in trueness and precision values in both in vitro and clinical studies. Peripheral borders, the inner seal, and poorly traceable structures like the soft palate showed maximum discrepancies. The accuracy of intraoral scanners in recording clear anatomic landmarks like hard tissues with attached mucosa was comparable to conventional edentulous arch impressions. However, higher discrepancies were recorded when digitizing mobile and poorly traceable structures. Intraoral scanners can be used to digitize denture-bearing areas, but the interpretation of the peripheral border and the soft palate should be carefully carried out. [ABSTRACT FROM AUTHOR]

Xerostomia and hyposalivation are highly prevalent conditions in old age, particularly among multimorbid elders, and are often attributed to the use of multiple medications. These conditions negatively affect oral functions, such as chewing, swallowing, speech, and taste. Additionally, the lack of lubrication of the oral mucosa frequently leads to super-infections with candida. Denture retention and comfort may also be compromised. The risk of dental caries and erosion of natural teeth increases since saliva, which is essential for repairing initial lesions in tooth structures, is insufficient. The dry sensation in the mouth also impacts the emotional and social well-being of elderly individuals. Patients experiencing xerostomia often avoid certain foods that are uncomfortable or difficult to consume. However, some foods may alleviate the symptoms or even stimulate salivation. This review discusses the limited available evidence on nutritional advice for patients with xerostomia and aims to provide insight into the patient's perspective while offering clinical recommendations. Future studies should focus on investigating the nutritional intake of individuals suffering from xerostomia or hyposalivation in order to ensure oral health comfort, prevent malnutrition, and minimize the impact on their quality of life. [ABSTRACT FROM AUTHOR]

Background: Masticatory function declines with age or disease, implicating a poor chewing efficiency and an often‐unconscious change for a less healthy, yet easy to chew diet. Timely screening of masticatory function may foster an early‐onset diagnosis and potential treatment. The aim of this study was to compare alternative diagnostic tools for masticatory function to a Jelly‐scan test. Materials and Methods: Patients aged 70 years and older who were hospitalised for rehabilitation were recruited for this study. A total of four different tests for masticatory function were administered. The Japanese Society of Gerodontology glucose extraction test [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition and risk of malnutrition continues to be a common finding in elders, yet its association with oral function in hospitalised patients remains unclear. Material and methods: Patients aged 70 years or over who had been hospitalised for non‐acute rehabilitation were recruited. Nutritional risk was screened using the Mini‐Nutritional Assessment Short Form (MNA‐SF) and Nutritional Risk Screening (NRS) scores. Malnutrition was assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. All participants underwent the oral hypofunction test battery, evaluating oral hygiene, oral dryness, occlusal force, tongue‐lip motor function, tongue pressure, masticatory and swallowing function. Statistical analyses comprised Mann‐Whitney or Kruskal‐Wallis tests. Bivariate associations between categorical variables were tested using the Pearson chi‐square test; for continuous variables, the Spearman correlation was calculated. A P‐value <.05 was considered statistically significant. Results: Sixty patients aged a mean 82.5 ± 7.0 years participated. Some 88.3% were diagnosed with oral hypofunction, and this was more common in older patients (P =.020). Analysing the 7 oral hypofunction tests as an interval variable (NiOF) revealed additional correlations with number of teeth (ρ = 0.477) as well as the nutritional risk, evaluated by the MNA‐SF (ρ = −0.284) and NRS (ρ = 0.317) scores. NiOF scores were higher among denture wearers (P =.003). GLIM did not confirm the correlation with NiOF. Biomarkers such as serum albumin and CRP were not associated with the NiOF score. Conclusion: In this sample, the association between oral function and nutritional state is more obvious in nutritional risk scores than in the malnutrition diagnosis by GLIM. [ABSTRACT FROM AUTHOR]

Introduction: Reduced tongue pressure may render eating and swallowing difficult. The purpose of this study was to investigate whether the tongue training device can also be used as a diagnostic device and whether its sensitivity and specificity are equal to the numerical tongue pressure measuring device. Material and Methods: The target group is patients aged 70 years and over who are hospitalised for rehabilitation. Tongue pressure was measured by both, a tongue pressure measuring instrument and a tongue training tool. The diagnosis of the reduced tongue pressure was made with the tongue pressure measuring instrument and set the verified with the novel tongue training tool. Results: Sixty‐two participants were included in the study. Forty‐five were classified by the tongue pressure measuring device and 53 by the tongue training device as 'low tongue pressure'. Spearman correlation confirmed a positive correlation between the tongue pressure measuring device and the tongue training device rs = 0.800, p = 0.01 level (2‐tailed). The tongue training device test identified sensitivity was 100%, and its specificity was 52.9%. The AUC of the ROC curve is 0.901. Conclusion: The tongue training device seems a simple, safe and readily available alternative to the tongue pressure measuring device for the diagnosis of low tongue pressure, with an excellent sensitivity and very good specificity. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess caregivers' knowledge, perception and perceived barriers as well as their daily usual practice concerning oral care provision in a geriatric hospital. Methods: A semi‐structured questionnaire was developed and administered to caregivers in a geriatric ward. Furthermore, oral care delivery to dependent and independent patients was clinically observed. Results: One hundred and fifty‐two caregivers (60% nurses, 40% nursing aids) completed the survey (78% response rate). Clinical oral care was observed in 97 inpatients. Observations revealed that brushing was done in 94% of opportunities in independent patients but in only 55% of dependent patients. This corresponded to the frequency indicated in the questionnaire for independent elders (97%, n.s.), whereas it was significantly different for dependent elders (89%, P <.001). 95% of caregivers stated in the questionnaire never verifying self‐administered oral care, whereas 12.3% were actually observed verifying intraorally its efficiency (P =.07 chi‐squared test). 71% of the respondents stated storing the prostheses dry, and 8% stated that they reinserted it after cleaning. Caregivers' observation revealed that 35.1% of prostheses were reinserted in the mouth, indicating a significantly higher rate than in the questionnaire (P <.05). Respondents felt that their training to perform oral hygiene measures was suboptimal (VAS 48 ± 34.4). Patients verbally refusing oral care were stated as a barrier by 14% of respondents and were witnessed in 15.6% of observation opportunities (n.s). Conclusion: Various measures, such as hospital health policy, improved logistics or advanced hands‐on training, might help to converge the clinical practice towards the theoretical knowledge. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study aimed to compare changes in retentive force due to cyclic dislodging of three novel un‐splinted attachments. Materials and Methods: Experimental models simulating a mandibular two‐implant overdenture situation, with implants positioned with various interimplant discrepancies (0°, 20°, 40°, and 60°) were fabricated. Three attachment systems were tested, "N": a straight or 15°‐angulated stud; "L": a sole straight stud; and "C": a straight or individually angulated stud. All models underwent wet testing and were subjected to 10,000 insertion–removal cycles in a universal testing machine. The mean retentive forces were calculated for cycles 10, 100, 1,000, 5,000, and 10,000. Multiple mixed‐effects linear regression models were applied for statistical analyses (⍺ < 0.05). Results: "N" demonstrated an increasing retention until 1,000 cycles, which subsequently diminished back to its initial retention at 10,000 cycles, showing no significant loss during the entire experiment. Statistical models demonstrated no effect of implant angulation on retention, except for 60° after 10,000 cycles (p <.05). "L" showed an early peak at 100 cycles and did not significantly lose retentive force before 5,000 cycles. Angulations of 40° or higher were shown to lead to lower retentive forces (0° vs. 40° cycle 5,000: p <.05; 0° vs. 60° cycle 100: p <.05, ≥cycle 1,000: p <.001). "C" showed stable retentive forces with no significant loss only at 10,000 cycles (all angles: p <.001) or 5,000 cycles (0° vs. 60°: p <.05). Conclusions: All systems showed retentive forces promising successful clinical use in implant overdentures, even in situations with extremely angulated implants. Specific abutments compensating interimplant angulation maintain retention longer in situations with high axe divergencies. [ABSTRACT FROM AUTHOR]

The purpose of thisin vitrostudy was to evaluate and compare the effectiveness of different surface cleaning methods on the shear bond strength (SBS) of zirconia ceramic surfaces. Seventy polished and cleaned zirconia disk specimens of 8 mm in diameter and 3.4 mm in thickness were immersed in fresh saliva. They were then pressed into a freshly mixed silicone disclosing medium. Six different cleaning methods were applied to the tested groups; they were airborne-particle abraded (AA), covered with a cleaning paste (Ivoclean®) (IV), etched with orthophosphoric acid (PA), immersed in alcohol (AL), rinsed with tap water only (WA), or cleaned with steam (SC). No surface cleaning was done after saliva immersion and silicone disclosing medium contamination to the control group (CC). The specimens were then bonded to an adhesive resin cement using polyethylene tubes. SBS was determined using a universal testing machine at a crosshead speed of 1 mm/min. The specimens were also examined with a scanning electron microscope and a stereomicroscope. Group AA yielded the highest SBS value (7.01 ± 1.4 MPa) among the groups, while Group WA had the lowest SBS value (3.03 ± 0.8 MPa). The SBS values of Group AA (7.01 ± 1.4 MPa) and IV (6.2 ± 1.7 MPa) were also significantly higher than those of the remaining four groups (p < 0.05). Within the limitations of thisin vitrostudy, it was concluded that among the various cleaning methods tested, airborne-particle abrasion and Ivoclean® paste were effective in cleaning the zirconia surface. [ABSTRACT FROM PUBLISHER]

The objective of this study was to explore the preferred dental services of older people for when they become dependent. It aimed to assess their preferred type of health care professional and location of dental service, and relate their preferences to their willingness to pay (WTP) and willingness to travel (WTT). Older people aged 65 years or older were invited to participate in a questionnaire-based discrete choice experiment (DCE), to measure preferences for dental examinations and treatment, defined by two attributes: type of professional and location of the activity. Hypothetical scenarios based attributes were displayed in a projected visual presentation and participants noted their personal preference using a response sheet. Data was analyzed using a random-effects logit model. Eighty-nine participants (mean age 73.7 ± 6.6 years) attended focus group sessions. Respondents preferred that the family dentist (β: 0.2596) or an auxiliary (β: 0.2098) undertake the examination and wanted to avoid a medical doctor (β: –0.469). The preferred location for dental examination was at a dental practice (β: 0.2204). Respondents preferred to avoid treatments at home (β: –0.3875); they had a significant preference for treatment at the dental office (β: 0.2255) or in a specialist setting (β: 0.1620, ns). However, the type of professional did not have a significant influence on overall preference. Participants with a low WTP preferred examination at home (β: 0.2151) and wanted to avoid the dental practice (β: –0.0235), whereas those with a high WTP preferred the dental office (β: 0.4535) rather than home (β: –0.3029). WTT did not have a significant influence on preference. The study showed that older people generally preferred receiving dental services in a dental practice or specialist setting, and would prefer not to be treated at home. Continuity of dental services provided by the family dentist should therefore be prioritized where possible and further studies should examine the role of domiciliary care at home.